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Open Access 01-10-2017 | Computed Tomography

CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?

Authors: Emina Talakić, Silvia Schaffellner, Daniela Kniepeiss, Helmut Mueller, Rudolf Stauber, Franz Quehenberger, Helmut Schoellnast

Published in: European Radiology | Issue 10/2017

Abstract

Objectives

To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis.

Methods

Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL). Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension (≥12 mmHg) were calculated.

Results

The Spearman correlation coefficient was −0.53 (p < 0.05) between SAF and HVPG, and −0.68 (p < 0.01) between HVPG and SCL. Using a cut-off value of 125 ml/min/100 ml for SCL, sensitivity for detection of a HVPG of ≥12 mmHg was 94%, and specificity 100%. There was no significant correlation between hepatic perfusion parameters and HVPG.

Conclusion

CT perfusion in patients with cirrhosis showed a strong correlation between SCL and HVPG and may be used for detection of severe portal hypertension.

Key points

• SAF and SCL are statistically significantly correlated with HVPG

• SCL showed stronger correlation with HVPG than SAF

• 125 ml/min/100 ml SCL-cut-off yielded 94 % sensitivity, 100 % specificity for severe PH

• HAF, PVF and HPI showed no statistically significant correlation with HVPG

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Title: CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?
Authors: Emina Talakić
Silvia Schaffellner
Daniela Kniepeiss
Helmut Mueller
Rudolf Stauber
Franz Quehenberger
Helmut Schoellnast
Publication date: 01-10-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 10/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4788-x

At a glance: The STEP trials

Springer Medicine

CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?

Abstract

Objectives

Methods

Results

Conclusion

Key points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key points

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